Quality of Care Network Working to Reduce Maternal and Newborn Deaths in 10 Countries

The ASSIST Project is working on a few initiatives, including implementing new maternal and child care standards.

Although significantly more women receive skilled health care during childbirth now than in past decades, the rate of maternal and newborn deaths remains unacceptably high, according to the World Health Organization (WHO). WHO estimates that every year, 303,000 mothers and 2.7 million newborn infants die around the time of childbirth.

To address this issue, a coalition of 10 countries – with support from development organizations and stakeholder groups, including URC – launched an effort a year ago to cut in half the number of maternal and newborn deaths in network learning facilities within five years.

Finding and Testing Best Practices for Care

The effort, known as the Quality of Care (QoC) Network, is working to improve the quality of care for pregnant women, newborns, and children in selected facilities in 10 countries. Bangladesh, Côte d’Ivoire, Ethiopia, Ghana, India, Kenya, Malawi, Nigeria, Uganda, and Tanzania joined forces to establish the QoC Network, which is supported by the World Health Organization (WHO), USAID, United Nations Children’s Fund (UNICEF), Bill and Melinda Gates Foundation, and others.

The USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project – implemented by URC – has been involved in the Network activities from its inception. At the global level, ASSIST, as the QoC Network’s technical resource partner, co-chairs with WHO the Network’s technical working group on implementation and participates in the monitoring technical working group.

“We help to co-develop implementation guidance, monitoring framework, and other tools of the network’s activities to learn from and scale up the best improvement practices within and between countries,” said URC Senior Quality Improvement Advisor Tamar Chitashvili, M.D.

ASSIST, in close collaboration with WHO, is supporting prioritization and field testing of the pediatric quality of care measures and development of guidance for health facility teams to operationalize maternal and newborn care standards.

Getting Results from Focusing on Patient’s Needs

At the national level, ASSIST is supporting 15 health facilities in the two QoC learning districts of Northern Uganda to improve labor monitoring, strengthen the referral systems for mothers and babies requiring further care, and provide respectful, dignified childbirth services that are responsive to mothers’ needs and preferences.

With URC’s support to the Ministry of Health coaching teams, facility teams have instituted daily exit interviews with mothers using a standard interview guide, improved privacy and companionship during childbirth, and established referral pathways with information exchange – both via phone and written – to improve coordination and communication during referral.

“This effort is in its early stages, but we’re already seeing positive trends,” said Esther Karamagi, MBChB, MSc, Uganda Chief of Party for ASSIST.

Improved attention to patients’ needs at supported health facilities may have contributed to a 13 percent increase in institutional deliveries from the baseline.

URC is planning to scale up best maternal, newborn, and child health improvement practices achieved by demonstration health facilities in eight districts of the northern Uganda.

Midwives practice resuscitating a newborn at Anaka Hospital in Northern Uganda. The USAID ASSIST Project, led by URC, is supporting 15 health facilities in two districts of Northern Uganda as part of a larger effort to reduce maternal and newborn deaths.